Summary:
The majority of advanced ovarian cancer patients achieve an objective response following chemotherapy; however, only 20–30% are in remission after 5 years. Intraperitoneal or high-dose chemotherapy (HDC) may prolong disease-free and overall survival (OS) in patients with platinum-sensitive, small volume disease. To better define the subsets of patients who might benefit from HDC, we performed a retrospective analysis on 91 patients in 1st complete remission (CR) treated from 21 centres of the EBMT group. At a median follow-up of 48 months, median time-to-progression (TTP) and OS were 21.2 and 44.4 months, respectively. Tumour grade, stage, residual disease, disease status before HDC, type and year of transplant, source of haemopoietic progenitors and use of haemopoietic growth factors (HGF) after transplant were analysed for TTP and OS. The only significant parameter was the use of HGF: median OS for patients receiving or not receiving HGF was 46.2 vs 17.8 months, respectively (P: 0.035); this difference was maintained after multivariate analysis (P: 0.02). Our analysis does not identify any subgroup of patients in 1st CR who can benefit from HDC; however, median survival of patient with no residual disease has not been reached. The role of HGF after HDC deserves further investigation.
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The following Institutions provide information on their patients and we are grateful to all contributors who assisted us in the collection of these data: University College London Hospital (AH Goldstone, JA Ledermann), London, UK; Centre Val D'Aaurelle (M Fabbro), Montpellier, France; Centre Hospitalier Louis Pasteur (B Audhuy), Colmar, France; Hopital Laennec (J Andrieu), Paris, France; Centre Leon Bernard (P Biron), Lyon, France; Wilhelminenspital (H Ludwig, Vienna, Austria; Centre Jean Pierrin, (H Cure) Clermond–Ferrand, France; Hopital Tenon (JP Lotz), Paris, France; Klinikum Nurnberg, (H Wandt), Nurnberg, Germany; Policlinico Università (R Sabbatini), Modena, Italy; Hopital De Hautepierre (B Lioure), Strasbourg, France; St. Savas Hospital (A Efremidis), Athens, Greece; Ospedale Civile (G Rosti), Ravenna, Italy; Hospital Infantil La Paz (AM Martinez-Rubio), Madrid, Spain; Ospedale S Camillo (L De Rosa), Rome, Italy; Charles University Hospital, (T Kozak), Prague, Czech Republic; University Hospital (P Bojko), Essen, Germany; Hopital Erasme (W Feremans), Brussels, Belgium; Stadt. Kliniken Oldenburg (B Metzner), Oldenburg, Germany; Ludwig Boltzmann Institut fur Stammzelltransplantation, (W Hinterberger), Vienna, Austria; Hopital d'Enfants, (P Bordignoni), Nancy, France; University Hospital, (C Bengala), Pisa, Italy.
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Bengala, C., Guarneri, V., Ledermann, J. et al. High-dose chemotherapy with autologous haemopoietic support for advanced ovarian cancer in first complete remission: retrospective analysis from the Solid Tumour Registry of the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 36, 25–31 (2005). https://doi.org/10.1038/sj.bmt.1705007
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DOI: https://doi.org/10.1038/sj.bmt.1705007
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